491: Neurodevelopmental assessment in patients who underwent prenatal fetoscopic and open fetal neural tube defect repair

Abstract

To compare neurodevelopmental outcomes in infants who had undergone prenatal neural tube defect (NTD) repair by either a Fetoscopic or by an Open hysterotomy approach 41 infants were included (22 Fetoscopic and 19 Open) in this prospective longitudinal cohort study. Neurodevelopmental outcomes were assessed using the Developmental Profile 3 (DP-3) screening test, which evaluates 5 domains of development as documented in an interview with the patient’s parents. Results were compared to reference values. Infants were categorized as “Delayed and Below Average” if the standard score (SS) was ≤ 84 and “Average and Above average ” if the SS was ≥ 85. In addition, infants were clinically evaluated by a Developmental Pediatrician in our Spina Bifida Clinic, with a full evaluation and documented the motor development and the disparity (if any) between the anatomic and functional levels of the lesion. The Capute Scales test evaluates visual-motor problem solving (CAT Developmental Quotient -DQ-) and language abilities (CLAMS DQ). Results were categorized as “Delayed” if DQ <70, “Borderline” if DQ 70-84, and “Normal” if DQ > 84. Motor DQ scores were determined by the Gesell Developmental Scale The DP-3 test was performed on 22 infants after Fetoscopic repair and on 14 after Open repair (Table 1). Fetoscopically repaired infants were assessed at an earlier age than their Open counterparts, but no differences in neurodevelopmental outcome were detected. The Capute Scales were performed on 14 Fetoscopic and on 19 Open repair infants at a similar age (Table 2). No differences in CAT DQ, CLAMS DQ, Motor DQ or classification of developmental outcomes were detected. Improvement in functional level by 3 or more was noted in 33.3% of the Fetoscopic group and in 26.3% of the Open group (p=0.7) There were no significant differences in neurodevelopmental outcome between those infants who underwent a Fetoscopic NTD repair as compared to their Open repair counterpartsView Large Image Figure ViewerDownload Hi-res image Download (PPT)